at Humana in Rogers, Arkansas, United States
Humana Healthy Horizons is seeking a Value-Based Contracting Lead who will conduct all aspects of value-based payment (VBP) contracting including development, implementation, negotiation, and maintenance in alignment with segment strategy and goals. The Value-Based Contracting Lead requires in-depth understanding of VBP and the contracting process to support value-based programs.
+ Creates new contracts based on the VBP design and the business operational capabilities.
+ Integrates contract changes as needed for existing VBP programs.
+ Creates and oversees new contract approval process.
+ Collaborates with cross-functional areas to understand and align on VBP programs.
+ Communicates program overview including contract terms, payment structures, and payment rates to providers
+ Assists with associate and provider educational materials.
+ Negotiates program terms and analyzes financial impact of proposed terms.
+ Manages repository of contracts and key contract terms to support VBP administration.
+ Drives positive experiences and performance among participating providers.
+ Bachelor’s degree.
+ 3 or more years of contracting experience for a healthcare company.
+ 2 or more years of VBP contracting experience.
+ Proficiency in analyzing, understanding, and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
+ Experienced in negotiating managed care contracts with primary physician groups or other specialty providers.
+ Proven contract preparation skills, with an in-depth knowledge of Medicaid VBP methodologies.
+ Excellent written and verbal communication skills and experience presenting to varied audiences.
+ Ability to manage multiple priorities in a fast-paced environment.
+ Knowledge of Microsoft Office applications.
Work at Home Requirements
+ At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
+ Satellite, cellular and microwave connection can be used only if approved by leadership.
+ Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
+ Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
+ Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
+ Master’s Degree.
+ Experience with ACO/Risk Contracting.
+ Workstyle: Remote
+ Work Days & Hours: Monday – Friday; Eastern Standard Time (EST) with some flexibility.
+ Travel: Up to 10% possibly outside of your state of residence.
+ Vaccination Statement: Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Social Security Task
Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.
Scheduled Weekly Hours
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.